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Posts Tagged ‘Costs’

“The Trump administration informed a federal appeals court on Friday that the government would immediately halt payments to insurers that help millions of lower-income Americans afford coverage under the Affordable Care Act, formalizing a decision that could upend individual insurance markets across the country.

“Millions of seniors will soon be notified that Medicare premiums for physicians’ services are rising and likely to consume most of the cost-of-living adjustment they’ll receive next year from Social Security.

Higher 2018 premiums for Medicare Part B will hit older adults who’ve been shielded from significant cost increases for several years, including large numbers of low-income individuals who struggle to make ends meet.

“The Trump administration is slashing spending on advertising and promotion for enrollment under the Affordable Care Act, a move some critics charged was a blatant attempt to sabotage the law.

Officials with the Department of Health and Human Services, who insisted on not being identified during a conference call with reporters, said on Thursday that the advertising budget for the open enrollment period that starts in November would be cut to $10 million, compared with $100 million spent by the Obama administration last year, a drop of 90 percent. Additionally, grants to about 100 nonprofit groups, known as navigators, that help people enroll in health plans offered by the insurance marketplaces will be cut to a total of $36 million, from about $63 million.

“When it comes to providing healthcare as an employer, cost is a major concern. Under the Affordable Care Act (ACA), applicable large employers – organizations with 50 or more full-time employees and full-time equivalent employees — are required to offer insurance to 95% of their full-time staff.

” The Blue Cross and Blue Shield Association, which represents 36 Blue Cross and Blue Shield plans covering 105 million Americans, has just released a study of its members’ claims data in Obamacare exchanges 2014 and 2015. It confirms that Obamacare exchange enrollees are sicker and more expensive than enrollees in pre-Obamacare individual plans or employer-based plans.

Here I quote four of the study’s findings:

Members who newly enrolled in BCBS individual health plans in 2014 and 2015 have higher rates of certain diseases such as hypertension, diabetes, depression, coronary artery disease, human immunodeficiency virus (HIV) and Hepatitis C than individuals who had BCBS individual coverage prior to health-care reform.

Consumers who newly enrolled in BCBS individual health plans in 2014 and 2015 received significantly more medical care, on average, than those with BCBS individual plans prior to 2014 who maintained BCBS individual health coverage into 2015, as well as those with BCBS employer-based group health insurance.

” Bad things can happen when a government forecast proves to be way off.

There are mistakes, and then there are big mistakes. What the Congressional Budget Office’s latest report on federal subsidies revealed was a mistake of monstrousproportions on the part of the federal government.

Here’s what a forecasting error looks like
The Congressional Budget Office, or CBO, has been making projections on the future of Obamacare, and healthcare in general, for years. Initially, the CBO had projected that up to 21 million people would sign up for private health insurance using Obamacare’s transparent marketplace exchanges by 2016. However, that estimate has been substantially reduced to just 12 million. According to the Department of Health and Human Services, Obamacare enrollment totaled “about 12.7 million” as of the end of third enrollment period (Jan. 31, 2016). Ultimately, the CBO foresees private health enrollment via Obamacare topping out at between 18 million and 19 million people between 2018 and 2026.

Why such a huge difference in actual enrollment versus initial projections? To begin with, the government appears to have overestimated just how many people would sign up on private exchanges versus being enrolled via their employer. The data has thus far shown that nowhere near as many people as expected dropped out of employer-sponsored insurance to sign up on Obamacare’s marketplace exchanges, meaning there was a considerably smaller uninsured pool than initially anticipated. (more…)

” Well, the hammer has fallen: The largest health insurer in the U.S. has started pulling out of select Obamacare exchanges.

Five months ago UnitedHealth, which had been singing sunny songs to investors about its bright future on the exchanges, abruptly began crooning the blues. In an earnings call barely a month after executives assured investors that all was going swimmingly, they confessed that they were losing a ton of money on their Obamacare policies and described a pattern that sounded as if consumers were gaming the system — signing up for a few months, using a ton of services, and then canceling their policies. If this continued, they said, they would have no choice but to pull out of the exchange business. (more…)

“On Dec. 28, 2015, the IRS announced that it is granting an automatic extension for the 2015 information returns required of insurers, employers and certain other providers of Minimum Essential Coverage (MEC) under Section 6055 and 6056 of the Internal Revenue Code (IRC).

Coverage providers that need more time now have until March 31 to get Form 1095 to individuals and until June 30 to electronically file with the IRS. For providers not filing electronically, the deadline is May 31, 2016. (more…)

“The Affordable Care Act is confusing and complicated, which means that health insurance agents and brokers are needed to help consumers pick the best plans for them, Kevin Counihan, chief executive officer of Healthcare.gov, said Monday.

“It’s got plenty of opportunity to be made a little bit better,” Counihan said. “And I’m very hopeful and confident that as we get more adults in Congress that they’re all going to sit down, the two sides together, and they’re going to address some of these issues.”

Counihan spoke to about 20 brokers and agents at an event hosted in Baton Rouge by the Louisiana Association of Health Underwriters.

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2015 Open Enrollment

Here are 4 key dates you should know:

• November 15, 2014. Open Enrollment begins. Apply for, keep, or change your coverage.
• December 15, 2014. Enroll by the 15th if you want new coverage that begins on January 1, 2015. If your plan is changing or you want to change plans, enroll by the 15th to avoid a lapse in coverage.
• December 31, 2014. Coverage ends for 2014 plans. Coverage for 2015 plans can start as soon as January 1st.
• February 15, 2015. This is the last day you can apply for 2015 coverage before the end of Open Enrollment.